Surgical clip applying instrument



Oct. 4, 1932. J P. WEIS 1,880,569.

SURGICAL CLIP APPLYING INSTRUMENT INVENTOR.

Patented Oct. 4, 1932 UNITED STATES JOHN P. WEIS, OF NYACK, NEW YORKSURGICAL CLIP APPLYING INSTRUMENT Application filed September 27, 1930.Serial No. 484,767.

This invention relates to surgical instruments, more particularly tosurgical clip applying instruments, by means of which surglcal clips areapplied to the mouths of wounds or incisions for securing the edgesthereof together thereby doing away with the stitching thereof, theobject of the invention being to provide a simple, inexpensive andeilicient' instrument so constructed that the clips may be automaticallyand quickly applied and spaced at regular predetermined intervalsthereby avoiding delay especially when the patient is under ananesthetic.

Another important object is the provision of an instrument that may berotated or rolled along the wound successively applying the clips in aregular and orderly manner while at the same time so constructed as topermit the applied clips to be visible.

Metal clips are now commonly used for the purpose of closing woundssince they are more efficient than needle stitches especially as theycan be more quickly inserted and removed.

The common method of applying these metal clips has been to use a pairof tweezers or plyers to pick up each clip and apply it, this however isa slow and tedious process especially as the clips are small anddifficult to pick up in just the right position to be applied, and asthere is no guage or guide to assist in the application of the clipsthere is no regularity in the spacing thereof.

Various attempts have been made to improve upon these tweezers or plyerssuch as providing the tweezers with magazines but for various reasonsthese instruments were unsatisfactory and are not used, the oldfashioned or common tweezers being employed.

0 The present improvement embodies the tweezer principle while providingmeans for holding a large number of clips spaced predetermined distancesapart so that when the clips are applied the wound is closed in a 4smooth and sightly manner thereby avoiding ugly figurement in thehealing of the wound.

This improved instrument is not only convenient to operate and simple toload but is readily sterilized and one of the advantages thereof is thatdifferent sizes of clips may be simultaneously carried by theinstrument, or difierent kinds used therewith. That is to say, theinstrument is so constructed that clips all of one size or clips ofdifferent sizes may be carried in the instrument at the same time whileit is also so constructed that different designs of clips may be used.

Furthermore this improved instrument can be readily and quickly loadedand efficiently sterilized in readiness for use so that the clips may bequickly applied one after another in a regular and orderly manner.

In the present instance the instrument is so constructed that it willcarry 16 regularly spaced clips and is capable of closing a wound 7inches in length.

In the drawings accompanying and forming a part of this specificationFigure 1 is a side view of one form of this improved instrll ment heldin the hand in position to apply a c 1p.

Figure 2 is a partly cross-sectional View of Fig. 1 lookingin thedirection of the arrow and illustrates two difi'erent kinds of clipscarried thereby.

Figure 3 is a detail view of one of the clip holding members.

Figure 4 is adetail partly sectional View illustrating the manner ofholding the clips in place prior to the application thereof.

Figure 5 is a similar view illustrating the manner in which the clipsare bent or compressed into position.

Figure 6 illustrates different sizes and 1 kinds of wound clips whichmay be used in the instrument.

Figure 7 illustrates a somewhat difierent construction of theinstrument.

Figure 8 is a cross-sectional view taken on line 88 of Fig. 7 looking inthe direction of the arrow in said Fig. 7 and illustrating a clip inplace ready to be bent, and

Figure 9 is a similar sectional view to Fig. 8 illustrating the mannerin which the clip is compressed or bent.

Similar characters of reference indicate corresponding parts in theseveral views.

Before explaining in detail the present improvement and mode ofoperation thereof, I desire to have it understood that the invention isnot limited to the details of and arrangement of parts which areillustrated in the accompanying drawings, since the invention is capableof other embodiments, and that the phraseology which I employ is for thepurpose of description and not of limitation.

In the present improvement, as shown in Figs. 1 to 5, a pair of disks orplates v1 each provided with the desired number of regular- 1y spacedarms or fingers 2 made of spring steel is clamped between a pair ofdisks or washers 7, 8. The outer ends of these spring arms are suitablyformed as at 3, for the reception of clips and for this purpose anest isformed comprising side walls 4 and an end wall5to prevent displacementof the clips, the end wall 5 being bent over to assist in holding theclips in position. The plates 1 are secured together by screws 6 passingthrough the disks 7, 8 being threaded into the disk 8 and these disksare provided with openings as are also the plates 1 to form a bearingfor rotary movement of the parts upon a hub or axle made in two parts 9and 10 and secured together by screws 11, the hub members being reducedin diameter whereby the heads thereof will overlap the side walls 12 ofthe disks 7 and 8, and thus prevent any play of the clip holdingmembers. These hub members 9 and 10 have laterally extending portions 15slotted at their outer ends, as at 16, to provide side walls 17 betweenwhich are pivoted the clip bending arms or levers 18, one on each side,these levers being pivoted by pivots 19 and operate in the slots of thehub members. 2 Additional pivot holes 20 are provided in these leverswhereby the position of the levers may be changed should this benecessary when using different sizes of clips. These levers have securedthereto or formed as a part thereof a U-shaped spring 22 made of verythin steel and operative to return the levers away from the clip armsand also effective to maintain the clip members in alignment whenchanging the pivoted position thereof. This spring is suitably shaped sothat it will conveniently fit into the hand of the operator and, asstated, maintains the levers in their open position (Figures 2 and 4).The pivot-s 19 hold these levers in the slotted projecting portions ofthe hub and are formed by the ends of a hair-pin shaped handle or guard23 which also fits into the hand when the instrument is in use to steadyits position especially when the thumb and index finger are on theknurled portion25 of the levers. As these pivoted ends are a part of thehandle or guard 23 this simplifies the shifting of the pivots andprevents displacement or loss thereof. The levers or arms 18 areprovided with a pair of bent ends 24 and guiding and operating theinstrument.

In Figs. 7 and 9 Ihave illustrated a similar instrument constructed,however, with one resilient member or plate 1 and a rigid member 33, themember 1 having a series of spring arms or fingers 2. In this form ofinstrument, however a telescopic hub is provided which is also rotatablein the central bore as at.27 of the member 2. The outermember of thishub is provided with a pin28 located in a slotted portion of the innermember of the hub so that when this pin strikes against the insidefaceofthe plate 1 (see Fig. 8) further outward movement of the arm 41and its hub 26 is prevented. The inner member 29 of the hub 26 issecured by the cross pin 30 to a. hub 31 likewise mounted for rotarymovement in the central bore 32 of the rigid member 33 against the outerface of which the face 34 of the hub 31 rests and this hub 31 is formedment of the arm 42 while permitting inward.

movement thereof against the action of .a spring 37 located between theplate 1 anda socket portion 40 carried by the lever 41 for the thumb,one end of this spring pressing against a washer.7 secured to the member1 and the other end against a face 38 of thearm or lever 41, which isformed with a hollow thumb receiving portion or knob 40,.the armor'lever'41 being bent at its lower end as at 42 successively to engagethe resilient fingers or arms 2, thereby-to compress the same and closethe clips, as shown in Fig. 9., when pressure is exerted against theconcave knob 40.

The resilient member 1 and rigid member 33 are secured together bysuitable spacers 44 and screws 6, which spacers may be made of differentlengths so that by the mere changing of these spacers, different lengthsof clips may be used in the instrument.

The rigidmember 33 and resilient'arms 2- have the same number of clipreceiving'pockets or nests 45, in the present instance 16 pairs beingshown, those of the rigid 'member aligning with those of the resilientmember, whereby on the swinging of'the arm 41 into position 'to'engageeach resilient arm or rotating the spring arms 2 relatively to the arm41 a clip will be properly bent to close the Wound, when the arm 41 ispressed intoengagement with a spring arm or finger 2.

In this form of the instrument, all the clips are bent from one sidesince only one set of res'ilientarms or fingers is provided, whereas,

in the form .shownin Figs. 1 to 5, both sets of resilient arms orfingers may be compressed. 7

The clips having been properly set into the instrument and the wholesterilized, the instrument of either form may be readily and gentlyrolled along the wound and as each clip is brought into position, thearms or levers operated to compress or bend the clips into the woundedges so that the clips can be successively applied to the wound atequal distances apart, thereby resulting in a uniform application of theclips and thus presenting a more sightly appearance at all times whilethe clips are always held in proper po sition for application equallyspaced, thereby insuring proper healing of the wound free from scars.The instrument is easily cleaned, easy to handle, and the rollingcontact of the instrument is extremely gentle along the wound surface.

The instrument may be quickly loaded and is simple to operate and thereis a uniform bending or bowing of the clips, each being bent apredetermined amount while at the same time there is clear visibility atboth sides of the instrument while it is being used. It can be used witheither the right or left hand or reversed in either hand and rolledforward or backward in either direction, there being only one clip incontact with the wouno surface at any time.

In the form shown in Figs. 7, 8 and 9, the rigid member 33 is providedon its periphery with a knurled surface 46 forming sufficient tractionto facilitate the rolling along of the instrument with an even motionand as the clips are inserted along the sides of the wound, one at atime, the edges are drawn together from one side while, with the form ofinstrument shown in Figs. 1 to 5, both edges of the wound are drawntogether since the clips are equally bent from both sides.

In the loading of the instrument, it is merely necessary to insert theclips in any convenient manner between the spring arms, Figs. 1 to 5,as, for instance, by inserting one end of aclip in the nest of one armand pushing the opposite end into the nest of the other arm, and inFigs. 7 to 9, by inserting one end of a clip into the nest of the rigidmember 33 and then pushing the opposite end into the nest of a resilientarm or member 2 or vice versa as found most convenient, whereupon, afterthe instrument is loaded it is merely necessary to press the levers orarms 18 in Figs. 1 to 5, or 41 in Fig. 1 to compress the resilient armsand thereby bend or bow the clips in a manner which will be readilyunderstood, whereupon, when the clips are bent as these are then muchshorter in length, they will readily drop from the nests of theinstrument. Obviously, if it is desired to space the clips fartherapart, alternate resilient arms may be loaded or the in strument can bemade with differently spaced sets of clip holding arms to hold anydesired number of clips.

From the foregoing, it will be seen that I have provided a very simple,readily loaded, easily sterilized, comparatively inexpensive and easilymanipulated wound clip applying means in the form of a reel which may begently rolled along the wound and which will facilitate the applicationof the clips in an orderly and uniform manner without injury to thewound, thereby requiring the patient to remain under the anesthetic amaterially less time as compared with those cases where each clip mustbe separately picked up and separately applied.

It is to be understood that by describing in detail herein anyparticular form, structure or arrangement, it is not intended to limitthe invention beyond the terms of the several claims or the requirementsof the prior art.

Having thus explained the nature of my said invention and described away of constructing and using the same, although without attempting toset forth all of the forms in which it may be made, or all of the modesof its use, I claim:

1. A surgical instrument for applying wound clips comprising spacedmeans for engaging and holding the opposite ends of a series of clipsspaced one from another, each in readiness to be compressed, and meansfor compressing and thereby bowing the series of clips successively. 2.A surgical instrument for applym wound clips comprlsing resihent meansfor engaging and holding the opposite ends of.

a series of clips spaced one from another in readiness tobe compressed,and means for compressing and thereby bowing the series of clipssuccessively.

3. A surgical instrument for applying wound clips comprising a reelhaving means for holding a series of spaced clips, and means forsuccessively compressing the ends of the clips toward each other.

4. A surgical instrument for applying wound clips comprising rotarymeans for holding a series of spaced clips, and means for successivelycompressing the ends of the clips toward each other.

5. A surgical instrument for applying wound clips comprising rotaryresilient means for holding a series of spaced clips, and compressiblemeans for successively compressing the ends of the clips toward theother.

6'. A. surgical instrument for applying wound clips comprising rotaryresilient means for holding a series of spaced clips, and sprincontrolled compressible means for successively compressing the ends ofthe clips toward each other.

7. In a surgical instrument, the combination of a series of spacedresilient fingers constructed to hold wound clips, means for rotativelysupporting said fingers, and means for successively compressing thefingers, thereby to bend the clips.

8. A surgical instrument for applying wound clips comprising a series ofresilient fingers constructed to receive the clips, and means effectivesuccessively to engage the fingers to compress the ends thereor towardeach other, said means and fingers having a relative rotation.

9. A surgical instrument comprising a series of pairs of spacedresilient fingers supported for rotary movement and constructed toreceive wound clips, and means in position to compress the fingers andthereby the clips as the fingers are successively brought into positionto be applied.

10. A surgical instrument comprising a series of resilient clip holdingfingers, and means in position successively to engage said fingers,thereby to compress the same and thereby bend thewound clips.

11. A surgical instrument comprising a rigid circular member having clipreceiving means, a series of resilient fingers likewise having clipreceiving means, and means for compressing the fingers, thereby to bendthe clips.

12. A surgical instrument comprising a rigid circular member having clipreceiving means, a series of resilient fingers likewise having clipreceiving means, and means for compressing the fingers, thereby to bendthe clips and comprising an arm and a spring for returning the arm toits normal position.

*3. A surgical instrument comprising a rigid circular member having clipreceiving means, a series of resilient fingers likewise having clipreceiving means, and means for compressing the fingers, thereby to bendthe clips and comprising an arm and spring means for returning the armto its normal position, said arm and rigid member having finger rests.

14. A surgical instrument comprising a rigid circular member havingclipreceiving means, a series of resilient fingers likewise having ciipreceiving means, and means for compressing the fingers thereby to bendthe clips and comprising an arm and spring means for returning the armto its normal position, said arm and rigid member having fin er rests,and said arm being shittable to- C Ward and from the resilient members.

15. A surgical instrument for applying wound clips comprising two setsof spaced resilient fingers constructed to receive wound clips, meansfor supporting said fingers for shiftable movement, and means forcompressing said fingers,- thereby to bend the clips.

16. A surgical instrument for applying wound clips comprising two setsof spaced resilien fingers constructed to receive wound clips, means forsupporting said fingers for shiftable movement, and means for compress-I ing said fingers'thereby to bend the clips, said means comprising apair of spring connected pivoted levers.

17. A surgical instrument for applying wound clips comprising two setsof spaced resilient fingers constructed to receive wound clips, meansfor supporting said fingers for shiftable movement, and means forcompressing said fingers, thereby to bend the clips, said meanscomprising a pair of spring connected pivoted levers, and means forpivoting the arms for adjustment into difierent positions.

18. A surgical instrument for applying wound clips comprising two setsof spaced resilient fingers constructed to receive wound clips, meansfor supporting said fingers xfor shii'table movement, and means forcompressing said fingers, thereby to bend the clips, said meanscomprising a pair of pivoted spring connected levers having pivot holes,and means for pivoting the levers for adjustment into differentpositions and comprising a pair of pivots adapted to co-operate withsaid holes and a bent guard carrying said pivots.

19. A. surgical wound clip applying i11- strument comprising spacedmeans for holding the opposite sides of a series of clips suspended inspaced relation one behind another in readiness to be applied, and meansfor successively engaging said means, thereby to bend the clips fromboth sides thereoftoward each other.

20. A surgical wound clip applying instru-' clips as they aresuccessively brought into position to be applied.

21. A. surgical instrument comprising a series of resilient clip holdingfingers and means in position successively to engage said fingers,thereby to compress the same and thereby bend the wound clips whenpressure is exerted by the hand on said means.

22. A surgical instrument comprising a rigid circular member coupled toand spaced from a resilient circular member having nests for holdingclips therebetween, and means for compressing the resilient member whenpressure is exerted by the hand, thereby tose't and bend the clips.

Signed at Nyack, in the county of Rockland, and State of New York, this24th day of September, 1930.

' JOHN P. VVEIS.

